| NPI | 1295706307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10650000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 64275) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX h6836) | |
| 208D00000X General Practice (Licence: TX H6836) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-06-22 |