| NPI | 1295909968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NV 15250) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A124189) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2014-07-09 |