NPI | 1407097249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 252167) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NY 252167) |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: NY 252167) | |
Enumeration Date | 2009-03-06 |
Last Update Date | 2022-10-24 |