| NPI | 1669736948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 62689) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125061362) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2018012547) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301111452) | |
| Enumeration Date | 2012-07-01 |
| Last Update Date | 2022-03-23 |