| NPI | 1225294572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 125162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 237222) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2015-07-30 |