| NPI | 1437513322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT213381) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016022484) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2017-07-13 |