| NPI | 1285946434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD463275) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244602) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 270167) | |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2020-10-05 |