| NPI | 1376804922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD463510) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NY 303963) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 67005) | |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2023-07-07 |