| NPI | 1518909456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD0000042217) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A81641) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-01-26 |