| NPI | 1063592194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: CA G61814) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA 000000G61814) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-11-03 |