| NPI | 1295179737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q5955) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10047847) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2018-05-27 |