| NPI | 1194994509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS10201) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NY 244178) |
| 2085B0100X Radiology, Body Imaging (Licence: FL OS10201) | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2024-01-10 |