| NPI | 1275735235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD444564) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C7-0003758) |
| 2085B0100X Radiology Body Imaging (Licence: PA MD444564) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-19 |