| NPI | 1851480776 |
|---|---|
| Other Name | JAY KOONCE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TN 48349) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL28898) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2011-00273) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-03-31 |