| NPI | 1992291488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 15198) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A184664) |
| Enumeration Date | 2018-07-08 |
| Last Update Date | 2024-08-14 |