| NPI | 1194976142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2012-02234) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 60 250578) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2014-02-13 |