| NPI | 1447512348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD187362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR PG158433) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MDRE.ML.60472795) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2024-04-23 |