| NPI | 1467912352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL TRN29111) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN29111) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME151140) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2023-11-23 |