| NPI | 1437323409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 242709) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 242709) |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2012-05-09 |