| NPI | 1457713463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 34.015768) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD H91621) |
| 2085R0001X Radiology, Radiation Oncology (Licence: DC DO035025) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2022-08-23 |