| NPI | 1639239049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 206648) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MI 4301061949) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2022-05-02 |