NPI | 1861450611 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 231404) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 000000) |
Enumeration Date | 2006-05-02 |
Last Update Date | 2020-03-05 |