| NPI | 1235148495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C54309) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.095895) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-07-19 |