| NPI | 1093942534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0203X Radiology, Therapeutic Radiology (Licence: KY 45172) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-240344) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2016-01-01 |