NPI | 1659785665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME149072) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 288516) |
207R00000X Internal Medicine (Licence: PA MT207257) | |
Enumeration Date | 2014-06-17 |
Last Update Date | 2022-11-07 |