| NPI | 1326579715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2022-03000) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A158323) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-07-13 |