| NPI | 1427472240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 284864) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 63520 - 20) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2016-12-14 |