| NPI | 1497934202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 331731) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.098082) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036166670) | |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2025-01-03 |