| NPI | 1326275694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 28151) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.205601) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301506222) | |
| 208M00000X Hospitalist (Licence: LA MD.205601) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2022-06-01 |