| NPI | 1134416498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 298034) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: PA MD457379) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD457379) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2022-08-08 |