| NPI | 1528281607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G47581) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2025-03-14 |