| NPI | 1265440903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA08101800) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MD447343) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2023-09-12 |