| NPI | 1093793655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY NY183250) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0076765) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD049791L) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2021-11-22 |