| NPI | 1336433770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: OH 35-127795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN16012) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2017-04-10 |