| NPI | 1407915226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 50296) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G77889) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2022-07-13 |