| NPI | 1386955714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 277521) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D78518) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2016-07-27 |