| NPI | 1033377478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 148303-1) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 311118) |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2021-06-22 |