| NPI | 1184866758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 329713) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 241822) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 226998) | |
| Enumeration Date | 2009-03-29 |
| Last Update Date | 2024-05-07 |