| NPI | 1518429018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS17620) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO6693) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2024-03-25 |