| NPI | 1619957834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA06736500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 303765) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-07-12 |