NPI | 1982780912 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA04636400) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 146936-1) |
2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME60014) | |
Enumeration Date | 2006-10-31 |
Last Update Date | 2014-02-05 |