NPI | 1114916921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO 48492) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 236284) |
Enumeration Date | 2005-10-14 |
Last Update Date | 2021-04-22 |