| NPI | 1538368584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A126024) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI none) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2018-01-24 |