| NPI | 1467412049 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 23087) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 226072) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-10-18 |