NPI | 1134652753 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11628400) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175798) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CT 76491) | |
Enumeration Date | 2017-04-10 |
Last Update Date | 2025-09-09 |