| NPI | 1295171940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R6416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10046705) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2018-02685) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2024-03-26 |