| NPI | 1528202009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD443919) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA09497100) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2016-08-24 |