NPI | 1609815984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX G1020) |
Additional Taxonomies | 208D00000X General Practice (Licence: TX G1020) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2015-05-14 |