| NPI | 1942238423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ MA60224) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME161283) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-02-13 |