| NPI | 1962821066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12148700) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NJ 25MA12148700) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 284984) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 284984-1) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2024-04-12 |