| NPI | 1689760944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KY 03050) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 34.008732) |
| 2085R0001X Radiology, Radiation Oncology (Licence: ND 10311) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2024-05-10 |