NPI | 1003888488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0039328) |
Additional Taxonomies | 208D00000X General Practice (Licence: MD D0039328) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2023-04-04 |