| NPI | 1801109780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME110602) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KS 04-39818) |
| 2085R0001X Radiology, Radiation Oncology (Licence: MO 2017008341) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2021-05-07 |