| NPI | 1134135635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: CA A60804) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD25844) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A60804) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-04-05 |