| NPI | 1831142124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: PA MD055970L) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA06448400) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2014-03-28 |