| NPI | 1699718015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TN 48423) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 155889) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-10-09 |