| NPI | 1124511688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12206200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 74334) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2024-04-25 |