| NPI | 1447566591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 279926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116028298) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2021-12-20 |