| NPI | 1710326095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA10355700) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 294026) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2023-12-16 |