| NPI | 1871684837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NY 150165) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: CA G37929) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G37929) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA G37929) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-03-15 |