NPI | 1184627945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301042036) |
Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301042036) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2023-11-09 |