| NPI | 1871535633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 238079) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A93364) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2013-07-30 |