| NPI | 1013234368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 279105) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA ETL4945) |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 279105) | |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD459328) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NJ 25MA10782500) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA ETL4945) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD459328) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10782500) | |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2023-01-24 |