| NPI | 1215433420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 329758) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MT219714) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2024-05-10 |