| NPI | 1386645695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: FL ME81341) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 226279-1) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA08308900) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-03-08 |