| NPI | 1013113026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 27575) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115719) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-08-21 |