| NPI | 1326451642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10769700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT206281) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2021-06-24 |