| NPI | 1952306797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35-05-0604-M) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35050604) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-03-07 |