| NPI | 1548585276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CT 61333) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: RI MD16306) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA09933600) | |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2024-02-16 |