| NPI | 1891844031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD434228) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08582500) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT185248) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2025-04-14 |