| NPI | 1578593893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 128175) |
| Additional Taxonomies | 2085R0205X Radiology Radiological Physics (Licence: NY 128175) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-09-22 |