NPI | 1508813999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MB07521600) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 227867) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2016-12-06 |