| NPI | 1831137751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD451893) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NE 18467) |
| 2085R0001X Radiology, Radiation Oncology (Licence: OH 35091617) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2014-10-09 |