| NPI | 1679550958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MN 27169) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 23272) |
| 2085R0001X Radiology, Radiation Oncology (Licence: WI 81233) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2024-02-09 |