| NPI | 1396723474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD065438L) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: OH 35.125085) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.125085) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: PA MD065438L) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2020-10-25 |