NPI | 1790881852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 116442) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: NY 116442) |
Enumeration Date | 2006-09-16 |
Last Update Date | 2020-01-31 |