NPI | 1164822607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CA C23563) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C23563) |
Enumeration Date | 2014-09-03 |
Last Update Date | 2024-10-13 |