| NPI | 1851535504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A110291) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.121649) |
| Enumeration Date | 2009-04-25 |
| Last Update Date | 2022-12-01 |