| NPI | 1669735023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35134737) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NC 224313) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2019-10-31 |