| NPI | 1659334282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-29308) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2001018673) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2015-04-21 |