| NPI | 1801382379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A197894) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A197894) |
| 207R00000X Internal Medicine (Licence: MA 275728) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0098010) | |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2024-10-09 |