| NPI | 1710972849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35130569) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD070743L) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2022-07-21 |