| NPI | 1225188105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 318449) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA G85253) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2022-10-05 |