| NPI | 1033108782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA07886100) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CT 027674) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2022-10-13 |