| NPI | 1316396963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 88040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT211254) |
| Enumeration Date | 2016-06-05 |
| Last Update Date | 2021-06-28 |