| NPI | 1710478250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A185835) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 304704) |
| 207R00000X Internal Medicine (Licence: PA MT215077) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-03-21 |