| NPI | 1295728251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08890100) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0069535) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD430024) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2024-07-18 |