NPI | 1811192164 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-00768) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 237548) |
Enumeration Date | 2007-06-18 |
Last Update Date | 2020-09-18 |