| NPI | 1992729727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 15183) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 232098) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-07-22 |