| NPI | 1528223765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA08933100) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 048358) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2014-02-11 |