| NPI | 1407892722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA12518800) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA md418635) |
| 2085N0700X (Licence: PA md418635) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD418635) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA12518800) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA md418635) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2025-03-26 |