| NPI | 1306817077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25ma08385300) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 227257) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2008-05-31 |