| NPI | 1760407068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 194304) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07584100) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA07584100) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 194304) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-07-22 |