| NPI | 1194229120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12018000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 321593-01) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-02-01 |