| NPI | 1366510794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN MD26353) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.067235) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2024-12-18 |