NPI | 1154598480 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA10015600) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD443009) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10015600) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD443009) | |
Enumeration Date | 2008-05-15 |
Last Update Date | 2019-12-04 |