NPI | 1760490452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA08164300) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME56380) |
Enumeration Date | 2006-08-04 |
Last Update Date | 2025-07-01 |