| NPI | 1194041186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS015598) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 048043) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 268468) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB09244200) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2015-10-21 |