| NPI | 1144381542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 240392-1) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08780500) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD440475) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 570678) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 240392-1) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-03-15 |