| NPI | 1396204616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 306023) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 11311) |
| 207R00000X Internal Medicine (Licence: NY 306023) | |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2024-03-06 |