| NPI | 1184824088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME109336) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 243554) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2012-11-29 |