| NPI | 1326276437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2021-02302) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A128253) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125-055922) | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-09-15 |