| NPI | 1679717326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08566200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 15838) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA md436391) | |
| Enumeration Date | 2009-04-25 |
| Last Update Date | 2014-06-27 |