NPI | 1205098548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD452348) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11416000) |
Enumeration Date | 2008-06-27 |
Last Update Date | 2022-09-26 |