| NPI | 1598723652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 1731744) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VT 042-0016051) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2022-06-21 |