| NPI | 1588870042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ N A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 256930) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-06-28 |