| NPI | 1356517130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME160493) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A102935) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2023-09-05 |