| NPI | 1104186196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10034900) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT210191) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD14397) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD457815) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2022-07-21 |