| NPI | 1265880496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NY 328643) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175745) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2026-04-02 |