| NPI | 1780654913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: WV 20196) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL ME86687) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2024-10-02 |