| NPI | 1144716960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS20876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 275494) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1014399) | |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2024-07-23 |