| NPI | 1962520080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 092710) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA C128063) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2017-02-03 |