| NPI | 1871579292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08921000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 227251) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 248758) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD11564) | |
| Enumeration Date | 2005-12-18 |
| Last Update Date | 2025-09-15 |