| NPI | 1801866132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 143484) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 143484) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2018-04-19 |