| NPI | 1407169691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D82923) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P25859) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 261929) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2023-03-31 |