NPI | 1417924408 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 209920-1) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 209920) |
Enumeration Date | 2006-03-08 |
Last Update Date | 2023-06-28 |