NPI | 1518942408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA06861400) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA06861400) |
Enumeration Date | 2005-12-13 |
Last Update Date | 2021-02-17 |