| NPI | 1033542006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A132313) |
| Additional Taxonomies | 2085N0700X (Licence: CA A132313) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2024-08-13 |