| NPI | 1730146457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 16143) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 197363) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2021-11-09 |