| NPI | 1992153290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: SC 39475) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL39475) |
| 207R00000X Internal Medicine (Licence: SC LL39475) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC LL39475) | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2022-07-13 |