| NPI | 1730152679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-24666) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 104684) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2023-12-18 |