| NPI | 1407823727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA07874800) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NJ 25MA07874800) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2019-05-31 |