| NPI | 1558894469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 75709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN24667) |
| 2085R0001X Radiology, Radiation Oncology (Licence: FL TRN24667) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: OK 39548) | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-03-15 |