| NPI | 1467492926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A13124) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS005872L) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 67203) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-02-02 |