| NPI | 1417310681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 6407-851) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 6407-851) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2017-03-11 |