| NPI | 1083690929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0006273) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0006273) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2012-12-18 |