| NPI | 1972743607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB10751500) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS016505) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C2-0010224) | |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2023-01-04 |