| NPI | 1508880238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 1574231) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 157423) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2023-07-05 |