NPI | 1073562088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0041613) |
Additional Taxonomies | 174400000X Specialist (Licence: PA MD044122E) |
174400000X Specialist (Licence: MD D0041613) | |
174400000X Specialist (Licence: NY 205142) | |
Enumeration Date | 2006-05-08 |
Last Update Date | 2021-10-15 |