| NPI | 1033165774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 204237) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 95015) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NJ 72298) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME 95015) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 72298) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 204237) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA07229800) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2021-02-03 |