NPI | 1003812488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35060850L) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD072499L) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2024-11-04 |