NPI | 1538428453 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 13613) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09451500) |
Enumeration Date | 2012-05-12 |
Last Update Date | 2025-07-30 |