NPI | 1174766802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 298463) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA A115378) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NY 298235) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115378) | |
Enumeration Date | 2009-04-10 |
Last Update Date | 2019-08-28 |