| NPI | 1427155167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ MA56617) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD034427E) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2007-11-27 |