| NPI | 1396835153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: CA G74799) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G74799) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-11-03 |