| NPI | 1700030160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD437116) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 249718) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2024-09-26 |