| NPI | 1356514517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 47276) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 36207) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2023-11-15 |