| NPI | 1942887575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A181998) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA PTL6985) |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2022-10-01 |