| NPI | 1538157938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 219421) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35089195) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2022-06-15 |