| NPI | 1720181167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200000669) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 200000669) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA TM203) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2025-09-02 |