| NPI | 1023073822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M1421) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M1421) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2022-12-29 |