| NPI | 1508813999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MB07521600) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 227867) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-12-06 |