| NPI | 1316264328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12786200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 27076) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 83026) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 277384) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2025-09-16 |