| NPI | 1952560369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 251308-01) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2024-07-31 |