| NPI | 1265430433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MB06502100) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 173393) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2022-02-10 |