| NPI | 1932193034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO 49811) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35063013) |
| 2085R0001X Radiology, Radiation Oncology (Licence: KY 33578) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2013-12-17 |