| NPI | 1093747669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301079632) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A94126) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-01-28 |