| NPI | 1548797913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD480332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301112331) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2023-08-08 |