| NPI | 1194780759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 232187) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI 19593) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 217715) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2024-10-03 |