| NPI | 1013900836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35056482) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY 33388) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2016-08-25 |