| NPI | 1578679130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: ND 3781) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KS 0432003) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2019-05-03 |