NPI | 1245559194 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB09715500) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: ND 21074) |
Enumeration Date | 2010-05-18 |
Last Update Date | 2024-05-28 |