| NPI | 1639494784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25IA12447800) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A141386) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2025-09-03 |