| NPI | 1285920637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A122995) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0083392) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 288090) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-07-21 |