| NPI | 1811915291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35088880) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: KY 37135) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-02-25 |