| NPI | 1699745315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07881600) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 211-469) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2018-03-12 |