| NPI | 1235308347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH Training license) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.095219) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2023-03-07 |