| NPI | 1164628467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 317511) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 84059) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23821) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D70681) | |
| Enumeration Date | 2007-06-23 |
| Last Update Date | 2024-05-09 |