| NPI | 1629129341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA C149156) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 249421) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NM MD2011-0407) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2021-12-21 |