NPI | 1043338163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G58639) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA G58639) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2012-12-19 |