| NPI | 1225033426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 2002-00658) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ MA63705) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: SC 23338) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 198604-1) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2022-04-26 |