| NPI | 1891937454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: AZ 006946) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.056794) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125.056794) | |
| Enumeration Date | 2009-03-28 |
| Last Update Date | 2020-11-17 |