| NPI | 1316956717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A81355) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 294611) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-03-08 |