| NPI | 1598886897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: MA 249953) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD441007) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 224644) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: NH 15486) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2018-03-28 |