| NPI | 1467686246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA 61245495) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A123195) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 53927) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2022-07-20 |