| NPI | 1497881106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12871500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 235100) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2025-09-17 |