| NPI | 1689949257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09270800) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A129394) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2025-03-25 |