| NPI | 1447413802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A144016) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX 123859) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2025-03-12 |