| NPI | 1114231479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2020008441) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 270527) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2020008441) | |
| 208M00000X Hospitalist (Licence: NY 270527) | |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2021-02-27 |