| NPI | 1902079262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07852100) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D67755) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2010-07-02 |