| NPI | 1881692978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: KS 04-22693) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: OK 14844) |
| 2085R0001X Radiology Radiation Oncology (Licence: MO R4J03) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2021-06-22 |