| NPI | 1760421432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ MA53386) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G073741) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-08-28 |