| NPI | 1942248240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 235905) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 235905-1) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2013-03-11 |