| NPI | 1992981179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 003978) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 271382) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2023-07-06 |