NPI | 1578721593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101242425) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 246121) |
174400000X Specialist (Licence: NY 246121) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09064100) | |
Enumeration Date | 2008-05-27 |
Last Update Date | 2013-10-17 |