| NPI | 1932208568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101280265) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 134786-1) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G88069) | |
| 174400000X Specialist | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-10-09 |