| NPI | 1538113048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301092790) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G38773) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-10-23 |