| NPI | 1558341073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA04954900) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD044468L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 57368) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16797) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2025-08-20 |