NPI | 1295728251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08890100) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0069535) |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD430024) | |
Enumeration Date | 2005-08-25 |
Last Update Date | 2024-07-18 |