| NPI | 1669444030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-28226) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 113711) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2023-09-27 |