NPI | 1114300803 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD472909) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264683) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2021-05-28 |