| NPI | 1245344431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.074278) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0067105) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 183421) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-04-05 |