| NPI | 1649341637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12149900) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 231516) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2026-01-23 |