| NPI | 1467656017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: NJ 25MA09434400) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: NY 253000) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2026-10-02 |