| NPI | 1801382379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0098010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 275728) |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2023-08-18 |