| NPI | 1073045993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-01111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2021-01111) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-06-27 |