| NPI | 1144201831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NJ 25MA06930500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA06930500) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2024-12-24 |