| NPI | 1982661641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: GA 028910) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 028910) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2022-01-13 |