| NPI | 1366479511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NY 174270) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MD041291E) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-06-21 |