| NPI | 1538206347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME135707) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A98116) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-09-01 |