| NPI | 1871541714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 18325) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 248245) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-02-05 |