| NPI | 1497753768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: WV 11545) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35054412) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2007-10-16 |