| NPI | 1093722308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS017499) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 252879) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 34009816) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 252879) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-09-12 |