| NPI | 1841477049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0079738) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P22032) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 315288) | |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2022-04-21 |