| NPI | 1427444280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD470420) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11328500) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11328500) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 324160) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2026-03-16 |