| NPI | 1447094974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2025021026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2024040076) |
| 207R00000X Internal Medicine (Licence: MO 2024021447) | |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2025-06-30 |