| NPI | 1386674281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A73260) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NV 11134) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2023-12-22 |