| NPI | 1437130796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101282170) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 91418) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2024-07-12 |