| NPI | 1255594289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E6198) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104534) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2026-04-13 |