| NPI | 1306888961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: DE C10007012) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MD D0062192) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA06557300) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2012-12-31 |