NPI | 1689615502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 1547881) |
Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NY 1547881) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2008-03-18 |