| NPI | 1841290772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 171770) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.152097) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2024-11-04 |