| NPI | 1730570326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A158319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125070136) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2023-10-27 |