| NPI | 1578876439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D79554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197558) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2025-04-02 |