| NPI | 1376854281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 271674) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A122632) |
| 2085B0100X Radiology, Body Imaging (Licence: CA A122632) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2023-02351) | |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2025-09-29 |