| NPI | 1740478494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 327126) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-39684) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036129117) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2025-12-11 |