| NPI | 1780926022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD466186) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.141093) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-01-26 |