| NPI | 1891089272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 077990) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL Training) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2021-01-13 |