| NPI | 1114151230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.123850) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.091496) |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2016-12-29 |