| NPI | 1417446337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA12067500) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D96713) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2024-04-25 |