| NPI | 1245686260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 290417) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 70831) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2024-12-19 |