| NPI | 1194266387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME154717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL41022) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2022-08-12 |