| NPI | 1215961750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME107577) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 207716) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-11-02 |