| NPI | 1942528716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 256358) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0103512) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0103512) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2025-04-22 |