| NPI | 1801899927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.097767) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NM 2000-180) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2022-10-13 |