| NPI | 1689629875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA07034700) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 1764691) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 1764691) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2023-01-26 |