| NPI | 1649790684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 90703) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.070677) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2022-08-29 |