| NPI | 1689604159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 191492) |
| Additional Taxonomies | 2085R0205X Radiology, Radiological Physics (Licence: NY 191492) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2011-11-04 |