| NPI | 1184184343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NY 311830-01) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: FL OS21580) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-02-22 |