NPI | 1124288915 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: IL 036139273) |
Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: NY 269667) |
2085N0700X Radiology Neuroradiology (Licence: NY 269667) | |
2085R0202X Radiology Diagnostic Radiology (Licence: WI 55374) | |
Enumeration Date | 2008-06-15 |
Last Update Date | 2016-08-06 |