| NPI | 1851851869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102206317) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102206317) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102206317) | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2021-01-27 |