| NPI | 1386958007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA09789000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT196695) |
| 207R00000X Internal Medicine (Licence: PA MT196695) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME163726) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MT196695) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD453573) | |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2024-05-14 |