| NPI | 1255764486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 299617-01) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D85678) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2023-04-28 |