| NPI | 1538588991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A139634) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 43853) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2023-02-28 |