| NPI | 1033360680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 047583) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 047583) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 252929) | |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2012-01-09 |