| NPI | 1407884737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0032653) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 32653) |
| 207R00000X Internal Medicine (Licence: CO DR.0032653) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2016-11-18 |