| NPI | 1437198082 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085N0700X (Licence: CA A76558) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A76558) | 
| Enumeration Date | 2006-06-06 | 
| Last Update Date | 2008-06-16 |