| NPI | 1598729584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD421780) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MA07787400) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2011-05-27 |