| NPI | 1336566272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 298670-1) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2020-08-14 |