| NPI | 1831119544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NJ MB4650239) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA OS007587L) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-07-07 |