| NPI | 1437122611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD421435) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD421435) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08828100) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-12-14 |