| NPI | 1477500528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: NJ MA42642) |
| Additional Taxonomies | 2085R0001X (Licence: NJ 25MA04264200) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-05-28 |