| NPI | 1386909000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 251747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251747) |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2013-11-30 |