| NPI | 1093324014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND RL-16715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V4961) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V4941) | |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2025-12-05 |