| NPI | 1639185580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 36882) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 240981) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-05-14 |