| NPI | 1639431992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 228104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251535) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2017-04-04 |