| NPI | 1326369943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10390300) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 278012-1) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-04-12 |