| NPI | 1669869137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC BP10052628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10052628) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2021-06-17 |