| NPI | 1295017762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA09192500) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D75875) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD445068) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 266480) | |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2016-04-05 |