NPI | 1659376952 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-17213) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS KS 04-17213) |
207Q00000X Family Medicine (Licence: MO MO R5059) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: MO R5059) | |
208D00000X General Practice (Licence: KS 04-17213) | |
Enumeration Date | 2005-06-15 |
Last Update Date | 2022-04-19 |