| NPI | 1164721676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2020-01152) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.128783) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2022-03-17 |