NPI | 1801044714 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 63909) |
Additional Taxonomies | 208D00000X General Practice (Licence: SC 35228) |
Enumeration Date | 2008-09-04 |
Last Update Date | 2013-08-29 |