| NPI | 1346225166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME61155) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G87531) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2021-06-25 |