| NPI | 1396783551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G24435) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G24435) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-09 |