NPI | 1558312884 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: MO 27600) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO MD27600) |
Enumeration Date | 2006-05-12 |
Last Update Date | 2015-06-15 |