| NPI | 1427282524 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08580500)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT184360)  | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD436358)  | |
| Enumeration Date | 2009-05-05 | 
| Last Update Date | 2014-07-14 |