| NPI | 1245530203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: IN 01075594A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57018444) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2020-12-08 |