NPI | 1548883721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 69620) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125076609) |
Enumeration Date | 2020-05-22 |
Last Update Date | 2021-07-12 |