| NPI | 1316032899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: NY 282388-1) |
| Additional Taxonomies | 2085R0001X (Licence: TX K9045) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-12-11 |