| NPI | 1023058989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 205401) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CT 044390) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2013-07-31 |