| NPI | 1851384671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: OH 35056721) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: KY 25998) |
| 2085R0001X Radiology Radiation Oncology (Licence: IN 01053774A) | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2024-07-01 |