| NPI | 1083875991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD448043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-054258) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2014-06-25 |