| NPI | 1962765172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10532300) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0061789) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A154175) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2025-07-28 |