NPI | 1285884767 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 12057) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 12057) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2008-09-22 |
Last Update Date | 2019-08-19 |