| NPI | 1659301125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 187268) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 187268) |
| 2085R0205X Radiology, Radiological Physics (Licence: NY 187268) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-04-11 |