| NPI | 1871563155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 23653) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 186748-1) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-07-21 |