| NPI | 1497322655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R80062) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R80062) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-05-16 |