| NPI | 1760944714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA12278500) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: FL TPME6883) |
| 2085R0001X Radiology Radiation Oncology (Licence: NY 319965) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-06-25 |