NPI | 1881633634 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 4455) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 4816) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2022-03-25 |