| NPI | 1215594361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0099523) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA PTL5567) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A182547) | |
| 208600000X Surgery (Licence: PA MT217443) | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2024-03-29 |