NPI | 1346537891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 22575) |
Additional Taxonomies | 208D00000X General Practice (Licence: MS 22575) |
Enumeration Date | 2011-07-06 |
Last Update Date | 2017-06-29 |