| 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 |