| NPI | 1841857984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD18718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04566) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2025-06-25 |