| NPI | 1659785327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 58647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301106105) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2023-09-08 |