| NPI | 1194176602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 335072) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD P33569) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC D94371) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D94371) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 125.073276) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.073276) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2025-06-05 |