| NPI | 1528471299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 35560) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105889) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-07-18 |