| NPI | 1689178675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NY 310939-01) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA11786800) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2025-03-08 |