| NPI | 1740209998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 035567) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12301500) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 60600) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 231576-1) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2026-06-18 |