| NPI | 1730341751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A152748) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25IA12550700) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2025-08-20 |