| NPI | 1447607650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NJ 25MA11413700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT211133) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2023-04-17 |