| NPI | 1952044042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 57.255112) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT225137) |
| Enumeration Date | 2022-04-16 |
| Last Update Date | 2023-07-30 |