| NPI | 1043912256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 197471) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 197471) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2024-12-07 |