| NPI | 1649217779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: PA MD019883E) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: NJ 68324) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2016-03-11 |