| NPI | 1821198482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 236572) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 236572) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 236572) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME118468) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2024-09-05 |