| NPI | 1740418896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD454270) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094349) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2020-08-30 |