| NPI | 1447426499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD437887) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: PA MD437887) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08727800) | |
| 2085B0100X Radiology, Body Imaging (Licence: NJ 25MA08727800) | |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2012-07-25 |