| NPI | 1922254598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD451859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-236648) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2015-05-05 |