| NPI | 1699162511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11095500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD20083) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD473060) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2024-06-18 |