| NPI | 1801258926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11800200) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NJ 25MA11800200) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2023-08-02 |