| NPI | 1255362679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A72847) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD27318) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-12-04 |