| NPI | 1235591900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-00208) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 217709) |
| 2085B0100X Radiology, Body Imaging (Licence: NC 2022-00208) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A153570) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-03-30 |