| NPI | 1932201613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NJ 25MA06686700) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: PA MD071013L) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: FL ME113844) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 66867) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME113884) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 248633) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD071013L) | |
| 208600000X Surgery (Licence: NY 248633) | |
| 208600000X Surgery (Licence: FL ME 113844) | |
| 208600000X Surgery (Licence: NJ 25MA06686700) | |
| 208600000X Surgery (Licence: MS 18289) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-06-05 |