| NPI | 1285950691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 256510) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D70383) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2012-02-01 |