| NPI | 1407800949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: PA MD471544) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA07269500) |
| 2085R0001X Radiology Radiation Oncology (Licence: NY 1905341) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-11-23 |