| NPI | 1144430422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A112857) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301086586) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-07-14 |