| NPI | 1881731560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 154278) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-002511) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX W0413) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-11-05 |