| NPI | 1417274143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA08746400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08746400) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2019-04-23 |