| NPI | 1447780705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 73323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101023293) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2023-06-15 |