| NPI | 1346227493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101270720) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD433209) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 200099) | |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2024-07-25 |