| NPI | 1871736108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MB09398100) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 2769431) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB09398100) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 2769431) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2016-12-01 |