| NPI | 1730344847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09318500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 55716) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2024-05-03 |