| NPI | 1538319090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104317) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: CA A104317) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2024-03-21 |