| NPI | 1841431145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 61003701) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 237975) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 267160) | |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2023-07-06 |