| NPI | 1447618350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL 163841) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 36774) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.142616) | |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2025-01-02 |