NPI | 1629086046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD430272) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: PA MD430272) |
2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA09271500) | |
Enumeration Date | 2006-08-03 |
Last Update Date | 2016-01-20 |