| NPI | 1346281284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA C145491) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: MI 4301082382) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C145491) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301082382) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-02-06 |