| NPI | 1578881892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 266577) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01882) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2016-06-03 |