| NPI | 1932310422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: KY 44409) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57011682) |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2014-02-21 |