| NPI | 1336171107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 10110) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G87406) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-12-18 |