| NPI | 1710190343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09828100) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NY 243323) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 243323) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD434130) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0009111) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2018-04-20 |