| NPI | 1275794935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: ID M12086) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A119515) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2018-01-10 |