| NPI | 1225293491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 254633) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NY 254633) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 254633) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA10047100) | |
| Enumeration Date | 2008-07-26 |
| Last Update Date | 2023-11-17 |