| NPI | 1588686745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: VT 0420008173) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 1021091) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 321950) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2025-01-21 |