| NPI | 1134127624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology Therapeutic Radiology (Licence: WV 12217) |
| Additional Taxonomies | 2085R0203X Radiology Therapeutic Radiology (Licence: OH 35045719) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2015-12-31 |