| NPI | 1730534520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OK 7571) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 651497) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 7571) | |
| 207R00000X Internal Medicine (Licence: TX 651497) | |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2023-11-21 |