| NPI | 1386633212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07668100) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NJ 25MA07668100) |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD422836) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD422836) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2019-01-04 |