| NPI | 1902877673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: KS 0426443) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: MO 118295) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2019-09-04 |