| NPI | 1992225841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10064960) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 271970) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 271970) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2023-11-08 |