| NPI | 1629459292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 303608) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-262958) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2020-06-18 |