| NPI | 1982845608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NJ 25MA09788100) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: PA MD445714) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2022-03-07 |