NPI | 1205276938 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD463294) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103743) |
2085R0202X Radiology Diagnostic Radiology (Licence: NY 287103) | |
2085R0202X Radiology Diagnostic Radiology (Licence: FL ME138951) | |
Enumeration Date | 2013-06-26 |
Last Update Date | 2021-09-09 |