| NPI | 1568699403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 291350) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA09885400) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2024-01-12 |