NPI | 1720658628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 39593) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 39593) |
208D00000X General Practice (Licence: OK 39593) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 39593) | |
Enumeration Date | 2021-07-01 |
Last Update Date | 2024-05-22 |