| NPI | 1821085663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07886900) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 235110) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-12-31 |