| NPI | 1467448886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 1159) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN DO0000001159) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2023-06-21 |