| NPI | 1699036939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D83433) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201657) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2022-07-21 |