| NPI | 1295926061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C193571) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 251042) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2024-10-23 |