NPI | 1962484394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 153566) |
Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: NY 153566) |
2085P0229X Radiology, Pediatric Radiology (Licence: NY 153566) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: NY 153566) | |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: NY 153566) | |
Enumeration Date | 2005-11-21 |
Last Update Date | 2016-07-12 |