| NPI | 1073044640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: IL 036171834) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: OH 35.145276) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-09-10 |