| NPI | 1124021423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA07552800) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0020114) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2009-02-27 |