| NPI | 1861782641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NJ 25MA11778300) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AZ 51685) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2023-06-13 |