| NPI | 1447787270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT214798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10060900) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-08-01 |