| NPI | 1194288373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 98888) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 10802) |
| 207R00000X Internal Medicine (Licence: GA 10802) | |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2024-02-28 |