NPI | 1740667096 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 307701) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10054304) |
2085R0202X Radiology Diagnostic Radiology (Licence: TX S8815) | |
Enumeration Date | 2015-05-06 |
Last Update Date | 2021-12-03 |