| NPI | 1326279738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 53628) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A114217) |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2019-01-30 |