NPI | 1164430534 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085B0100X Radiology Body Imaging (Licence: NJ 25MA02897400) |
Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NJ 25MA02897400) |
2085N0904X Radiology Nuclear Radiology (Licence: NJ 25MA02897400) | |
2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA02897400) | |
Enumeration Date | 2006-08-03 |
Last Update Date | 2007-07-08 |