| NPI | 1033183199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 188921) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 188921) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2015-07-07 |