NPI | 1295120541 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 334713) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2023011716) |
Enumeration Date | 2015-04-03 |
Last Update Date | 2025-06-17 |