| NPI | 1144515990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NC 200200231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL33644) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200200231) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2025-09-30 |