| NPI | 1396265856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101283848) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 272539) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 272539) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A175726) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-11-07 |