| NPI | 1235377334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 265496) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 049745) |
| Enumeration Date | 2009-01-27 |
| Last Update Date | 2021-05-27 |