| NPI | 1508271149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 0000000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 59884) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-14233) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10027400) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A144457) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD469983) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2025-09-09 |