| NPI | 1053307587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 274060) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 221303) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2014-10-13 |