| NPI | 1255836953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.147167) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0116032465) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-10-18 |