NPI | 1750812863 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 312180) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 312180) |
282N00000X General Acute Care Hospital | |
Enumeration Date | 2017-03-22 |
Last Update Date | 2024-09-15 |