| NPI | 1750324273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA03341800) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 103677-1) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-12-28 |