| NPI | 1801946975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 6895740-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 24032) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2023-11-27 |