| NPI | 1740416478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NC 2015-00215) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 253475) |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2020-06-15 |