| NPI | 1598382335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 79317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL16666) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.077402) | |
| Enumeration Date | 2020-06-27 |
| Last Update Date | 2025-05-12 |