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 |