| NPI | 1578563334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA05181300) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD042008E) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2024-06-07 |