| NPI | 1669444725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME102354) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 2233361) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2019-10-24 |