| NPI | 1205276938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD463294) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103743) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 287103) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME138951) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-09-09 |