NPI | 1518317569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: GA 90527) |
Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NC 2021-00816) |
208D00000X General Practice (Licence: SC LL35909) | |
Enumeration Date | 2016-06-20 |
Last Update Date | 2022-05-19 |