| NPI | 1083873434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NJ 439807) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2008-06-02 |