| NPI | 1205877578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35-058268) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 35058268) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-05-12 |