| NPI | 1871835231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: MA 274578) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NY 277852) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2018-08-07 |