| NPI | 1922277680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 002980) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 277632) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 002980) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2023-07-05 |