| NPI | 1245675800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MD D95725) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.134191) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2025-01-23 |