| NPI | 1467528778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G32766) |
| Additional Taxonomies | 2085N0700X (Licence: CA G032766) |
| 2085N0904X (Licence: CA G032766) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA G032766) | |
| 2085R0001X (Licence: CA G032766) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: CA G032766) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA G032766) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2023-11-27 |