| NPI | 1851572481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA07245800) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CT 37511) |
| 2085R0001X Radiology, Radiation Oncology (Licence: NY 211184-1) | |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2017-08-28 |