| NPI | 1689609083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MB03916900) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-10-03 |