| NPI | 1053583401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 243307) |
| Additional Taxonomies | 2085N0700X (Licence: NY 243307) |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2026-01-26 |