| NPI | 1386803591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 070074) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 003393) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 47217) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2022-01-13 |