NPI | 1154320273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA07640500) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME165574) |
Enumeration Date | 2005-07-20 |
Last Update Date | 2024-05-10 |