| NPI | 1376633313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 234303) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 234303-1) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-04-21 |