| NPI | 1326484692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 009545) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A14208) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2022-08-29 |