| NPI | 1144255993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ MA074671) |
| Additional Taxonomies | 2085N0700X (Licence: PA MD433701) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-07-30 |