| NPI | 1336133685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35058540) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: IN 01037124A) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 26204) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2023-02-20 |