| NPI | 1093989105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 283312) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 81731) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2016-06-29 |