| NPI | 1780880096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09129900) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NJ 25MA09129900) |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2013-07-12 |