| NPI | 1134361371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35-129630) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01074457A) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 46969) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2021-04-22 |