| NPI | 1114094430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 219430) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: VA 0101240892) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-08-03 |