| NPI | 1831695196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12204200) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 340160) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 83238) | |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-10-27 |