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 |