| NPI | 1922260033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A108502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A108502) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301106997) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-02-13 |