| NPI | 1578094322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11762500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 299458) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2023-07-17 |