| NPI | 1588729966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 257827) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 25376) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 257827) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 25376) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2024-04-25 |