| NPI | 1851313381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX E4443) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX E4443) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX E4443) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX E4443) | |
| 208600000X Surgery (Licence: TX E4443) | |
| 2086S0129X (Licence: TX E4443) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2023-10-26 |