| NPI | 1710516273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 284876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA ETLL1328) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2024-12-12 |