| NPI | 1053844209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0116031398) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76003) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-08-16 |