| NPI | 1144740861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NC 2019-02277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT214524) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2023-02-15 |