| NPI | 1306200837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 3013723) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC DO51272) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC DO51272) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-07-03 |