NPI | 1851654172 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: NE 1073) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: PA OS019478) |
208D00000X General Practice (Licence: NE 1073) | |
Enumeration Date | 2012-06-21 |
Last Update Date | 2024-04-11 |