| NPI | 1265518260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA06385400) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 194125-1) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2014-02-07 |