NPI | 1619016458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 38534) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 5917) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2022-07-21 |