| NPI | 1386660272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 070302) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD29637) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2014-09-08 |