| NPI | 1316436793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 276370) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 33075) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2024-06-21 |