| NPI | 1881785939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA04886600) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 37857) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 175751-1) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2023-12-16 |