| NPI | 1831196922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME60884) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 162764-1) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2024-02-22 |