| NPI | 1366428294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 183991-1) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA07030400) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07030400) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2026-05-21 |