| NPI | 1801956974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 159026) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA05601300) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-01-10 |