| NPI | 1548554769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NY 284099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 247518) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2020-05-06 |