| NPI | 1821528225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A160248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271362) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2023-03-07 |