| NPI | 1760445514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NC 2005-01558) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: NC 2005-01558) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2025-11-03 |