| NPI | 1689801391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 273798) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241602) |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2018-02-14 |