| NPI | 1336637628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A185768) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS T-3668) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2023-07-18 |