| NPI | 1881634723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 20515) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 20515) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2014-01-24 |