NPI | 1013531326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 312934) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-01667) |
Enumeration Date | 2020-06-02 |
Last Update Date | 2025-07-28 |