| NPI | 1659664985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-43447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-9140) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2022-07-29 |