| NPI | 1275516338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NY 252361) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA A90307) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2011-07-29 |