| NPI | 1982099818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 304309) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MA 266804) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-07-31 |