| NPI | 1265098313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD475207) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT221525) |
| 207R00000X Internal Medicine (Licence: TX BP10067161) | |
| 207R00000X Internal Medicine (Licence: PA MD475207) | |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2025-12-22 |