| NPI | 1932631710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: IA MD-53266) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35.144379) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2024-08-09 |