| NPI | 1083098669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.139313) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 44753) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2024-12-04 |