| NPI | 1205050739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 273258) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 54436) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-07-02 |