| NPI | 1023549482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0070130) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WA 60977106) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 291518) | |
| 207R00000X Internal Medicine (Licence: MA 271587) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2024-03-29 |