| NPI | 1427445626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME129865) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A168373) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2022-07-21 |