| NPI | 1326496225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 88321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 008282) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2024-02-15 |