| NPI | 1144208588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07444000) |
| Additional Taxonomies | 2085N0904X (Licence: NJ 25MA07444000) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2011-02-24 |