NPI | 1518175637 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D65836) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 53333) |
2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA08371500) | |
2085R0202X Radiology Diagnostic Radiology (Licence: AR E-14124) | |
Enumeration Date | 2007-05-21 |
Last Update Date | 2024-10-03 |