| NPI | 1568408771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NY 169941) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 169941) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2023-04-13 |