| NPI | 1285639997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 242436) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35-047483) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2010-03-09 |