| NPI | 1548209539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A82709) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDR.0004462) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2025-03-25 |