| NPI | 1093989105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A103456) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A103456) |
| 2085N0700X (Licence: CA A103456) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2025-03-27 |