| NPI | 1487670782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 60-250030) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MO 2005001573) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-09-30 |