| NPI | 1144519992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 287183) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NY 287183) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2023-07-07 |