| NPI | 1427072446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 139832) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WV 27180) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-09-28 |