NPI | 1871029538 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NY 322566) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: LA 309899) |
Enumeration Date | 2017-05-02 |
Last Update Date | 2024-03-27 |