| NPI | 1346343225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C38225) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 38225) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2009-12-04 |