| NPI | 1225249303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12812) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 243937-1) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2014-08-26 |