| NPI | 1255545653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA08267400) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: IL 036111937) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2017-01-23 |