| NPI | 1659674083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.126990) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.018402) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2022-11-15 |