| NPI | 1013928225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A67966) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2023-011) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2023-06-07 |