| NPI | 1386770527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 263648) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C70003511) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2023-05-01 |