| NPI | 1528081437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: PA MD-045031-L) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: OH 35-094475) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-09-09 |