| NPI | 1144344623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ MA04567600) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NY 168553) |
| 2085R0001X Radiology Radiation Oncology (Licence: PA MD0571701) | |
| 2085R0001X Radiology Radiation Oncology (Licence: KY 24981) | |
| 2085R0001X Radiology Radiation Oncology (Licence: WV 20705) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |