NPI | 1891061420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-02153) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA10744300) |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD460445) | |
Enumeration Date | 2012-03-28 |
Last Update Date | 2022-01-04 |