| NPI | 1174819577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA10108400) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: CA A142773) |
| 2085R0001X Radiology Radiation Oncology (Licence: NY 280507) | |
| 207R00000X Internal Medicine (Licence: PA MT200464) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-07-27 |