| NPI | 1578610382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OK 38749) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OR MD174329) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MO 2010015937) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2023-03-30 |