| NPI | 1932360658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA09276700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT193517) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09276700) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2021-02-17 |