| NPI | 1497722037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 223908) |
| Additional Taxonomies | 2085N0904X Radiology Nuclear Radiology (Licence: NY 223908) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2018-03-21 |