| NPI | 1013100098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07866800) |
| Additional Taxonomies | 2085N0700X (Licence: NY 244874) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-07-26 |