| NPI | 1740489418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09159500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 49954) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115256) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2015-02-24 |