| NPI | 1326420076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS020478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015019337) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2024-08-14 |