| NPI | 1841455789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085P0229X Radiology Pediatric Radiology (Licence: NJ 25MA07894300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07894300) |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2015-10-07 |