| NPI | 1427264779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301088379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301088379) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-11-15 |