| NPI | 1518183938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA05511500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 180428) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2025-11-03 |