| NPI | 1831874965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 72202) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY P121231) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2024-10-20 |