NPI | 1982845350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101259235) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 275813) |
Enumeration Date | 2009-03-16 |
Last Update Date | 2021-03-09 |