| NPI | 1508827833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 087891) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 087891) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2007-07-08 |