| NPI | 1386633238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 053687) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 053687) |
| 207Q00000X Family Medicine (Licence: GA 053687) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2022-08-23 |