| NPI | 1538363080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME125326) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115605) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2024-01-05 |