NPI | 1992813687 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NJ 25MA05095600) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NJ 25MA05095600) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA05095600) | |
Enumeration Date | 2006-08-25 |
Last Update Date | 2022-03-21 |