| NPI | 1669495768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07122200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 1994021) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-03-21 |