NPI | 1720084726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J4036) |
Additional Taxonomies | 208D00000X General Practice (Licence: TX J4036) |
Enumeration Date | 2005-06-23 |
Last Update Date | 2019-06-03 |