| NPI | 1366474728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 4833) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G51035) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2017-12-19 |