| NPI | 1063686624 |
|---|---|
| Former Name | WILLIAM WESLEY POTTS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036.130614) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.055740) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2013-02-04 |