| NPI | 1124352612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD047697) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094958) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D81840) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2023-07-05 |