| NPI | 1326309352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD61498444) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A128634) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2023-02059) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2024-11-19 |