| NPI | 1932285988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: MN 29477) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN 29477) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 29477) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-11-10 |