| NPI | 1194217331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NJ 25MA12315100) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12315100) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2024-08-14 |