NPI | 1306852504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1013573) |
Additional Taxonomies | 2085N0700X (Licence: NY 2477621) |
2085R0202X Radiology, Diagnostic Radiology (Licence: CA A108805) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: NY 2477621) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101277389) | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2025-06-05 |