| NPI | 1932177268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: OH 35125681) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ MA25MA07298200) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 1827981) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2016-07-27 |