| NPI | 1013917301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 214773) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM TM2010-0634) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2024-03-26 |