| NPI | 1851537740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08372600) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61328626) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 257220) | |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2024-08-30 |