| NPI | 1093915852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 262570) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA 443039) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09086500) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2023-08-21 |