| NPI | 1427589886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 316403) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11671900) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 316403) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11671900) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-04-08 |