NPI | 1588627756 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MO 2005013030) |
Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: KS 04-31351) |
Enumeration Date | 2006-04-10 |
Last Update Date | 2015-04-21 |