| NPI | 1023118627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 232908) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 232908) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2011-08-25 |