| NPI | 1134396351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME164227) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 283635) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2024-03-05 |