| NPI | 1326278862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301094674) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094674) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01074601A) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2015-06-11 |