| NPI | 1982780912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA04636400) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 146936-1) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME60014) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2014-02-05 |