| NPI | 1033200902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA G34484) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E-3119) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2023-07-05 |