| NPI | 1285364729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2023015986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022021316) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2023-06-29 |