| NPI | 1144435124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 068093) |
| Additional Taxonomies | 2085N0700X (Licence: GA 068093) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281466) | |
| 207R00000X Internal Medicine (Licence: MO 2004015135) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2024-03-07 |