| NPI | 1861786030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 267538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 72620) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 267538) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2024-02-05 |