| NPI | 1841297611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 51224) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 232410) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2016-11-01 |