| NPI | 1528131133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD047928) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 242636) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2023-02-08 |