| NPI | 1942731039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 328277) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D88556) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-02-29 |