| NPI | 1265559694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 257544) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2006013753) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA A129053) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-03-07 |