| NPI | 1427006667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA08554000) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: PA MD436590) |
| 2085N0700X Radiology Neuroradiology (Licence: NJ 25MA08554000) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD436590) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2018-04-20 |