NPI | 1134118284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 119853-1) |
Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 119853-1) |
Enumeration Date | 2005-10-20 |
Last Update Date | 2007-07-08 |