| NPI | 1629332812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA10145500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301101374) |
| 2085R0001X Radiology, Radiation Oncology (Licence: PA MD461991) | |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2023-05-22 |