| NPI | 1851320535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME163796) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35088256) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 53743) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2023-09-25 |