| NPI | 1023335288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME132510) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A133324) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2025-11-04 |