| NPI | 1306010806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA08312200) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NC 2010-00507) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2022-01-26 |