| NPI | 1295737583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9800790) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 282090) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2024-03-13 |