| NPI | 1184825416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115592) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A115592) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A4346982) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD12793) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-04-19 |