| NPI | 1386964500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: AZ 46373) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R72286) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2016-08-05 |