| NPI | 1467832212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 5101025420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101021836) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-07-14 |