| NPI | 1558312579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G49698) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 238657-1) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08122100) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2008-0777) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-05-22 |