| NPI | 1013138825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 245206) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ NJ25MB09990700) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD H0065390) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2024-10-01 |