| NPI | 1295350973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-19615) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 8300-851) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 72768) | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2025-07-22 |