| NPI | 1952563520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25ma08514300) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD436259) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME161818) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-03-21 |