| NPI | 1386096535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 59261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 59261) |
| 208M00000X Hospitalist (Licence: AZ 59261) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2023016228) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2023-11-20 |