| NPI | 1841279361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.140237) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WV 21718) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2021-08-16 |