| NPI | 1811155633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NY 237255) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: NJ 25MA08585400) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: CT 57129) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: NY 237255) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2022-08-31 |