| NPI | 1083274179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2024011866) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019020178) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2024-06-09 |