| NPI | 1225108673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 225452) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NY 225452) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2018-10-18 |