| NPI | 1235442963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD483642) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12374200) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0102917) | |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2025-05-05 |