| NPI | 1194461384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP20090009) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10080736) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2024-06-06 |