| NPI | 1679500128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD426672) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA0724600) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2023-05-20 |