| NPI | 1588157895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA11912600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT-216131) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2023-06-15 |