| NPI | 1821523846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 334507) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11816300) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 334507) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11816300) | |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2025-10-30 |