| NPI | 1518072701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.124976) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: PA MD054315L) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2022-03-08 |