| NPI | 1275574535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: OH 35-071641) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: KY 37561) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-04-22 |