| NPI | 1790197762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD467439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105263) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2024-09-04 |