| NPI | 1669633608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: IA MD-39436) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 39436) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 39436) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2025-04-24 |