| NPI | 1083943260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 255325-1) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A116262) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD037931) | |
| Enumeration Date | 2009-12-16 |
| Last Update Date | 2018-01-16 |