| NPI | 1538190947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA07324300) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 214179) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2018-03-17 |