| NPI | 1033777818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 83256) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125074624) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125074624) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2024-06-04 |