| NPI | 1730180662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD031694E) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.055346) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2024-02-19 |