| NPI | 1841440021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-44162) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NY 341652) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2026-01-15 |