| NPI | 1346636891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 309373) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11728000) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 309373) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11728000) | |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2024-01-11 |