| NPI | 1326123951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 301519) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 43468) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA a76025) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2022-11-17 |