NPI | 1023468717 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 293014) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2492) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2025-09-16 |