| NPI | 1992793756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07086300) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 222936) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2016-01-05 |