| NPI | 1467716969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301101576) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101576) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35136765) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2020-06-26 |