| NPI | 1275707614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD482412) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.136035) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2024-02-21 |