| NPI | 1003260456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD210001786) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.068434) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D91657) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2022-09-08 |