| NPI | 1821479924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 4301503962) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107877) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A166974) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-06-24 |