| NPI | 1730353491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 264174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY no license) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2022-01-24 |