| NPI | 1790987121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 324501) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: NY 324501) |
| 2085H0002X Radiology, Hospice and Palliative Medicine (Licence: PA MD441699) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD441699) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2024-04-16 |