NPI | 1447748736 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 32095) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 32095) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-23 |
Last Update Date | 2023-08-22 |