| NPI | 1164487435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2010-0292) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 187820) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-03-12 |