| NPI | 1194038364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R3260) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301097270) |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2018-03-17 |