NPI | 1275722977 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD439930) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08766900) |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD439930) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA08766900) | |
Enumeration Date | 2007-10-18 |
Last Update Date | 2013-02-15 |