| NPI | 1285614602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA03222600) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 60442) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2025-11-13 |