| NPI | 1720399546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD457330) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197836) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT197836) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-08-05 |