| NPI | 1518136951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A130746) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 234544) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2020-11-30 |