| NPI | 1952333718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD060244L) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA06914900) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD060244L) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA06914900) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-08-29 |